Monday, June 30, 2008

A big sigh of relief...

Although we're not completely out of the woods yet, I think I can safely say that for the duration of my pregnancy, I will have full maternity benefits through my insurance company. Whewee!!!

When I switched from COBRA to private insurance January 1, 2008, the stipulation was that Blue Cross/Blue Shield had a 10-month waiting period for maternity coverage...which would mean that if I became pregnant anytime during those 10 months, Johnny and I would be on our own to cover the expenses. Although we knew it was risky (and potentially expensive), Johnny and I decided to keep trying for a baby - we didn't want to postpone our plans for almost a year and we figured odds were that I wouldn't get pregnant right away.

Well...Bun was apparently anxious to arrive, because later that month, I DID become pregnant. Around this same time, I realized that my insurance application had been processed incorrectly - it was overlooked that I had checked the little "maternity coverage" box. I received my first month's invoice, and no maternity coverage was listed. (As I understood it, you pay the extra fee for maternity coverage during the 10 months in which you're waiting to be covered, so I fully expected to have a line item on the invoice that said something like, "Maternity coverage - pending 10 months." Since we were still trying (and even though Bun was probably saying, "Hello, I'm already here!), I was anxious to make sure that the 10-month countdown started as soon as possible. I spent several phone calls trying to make sure that the mistake would be corrected, and that January 1st would be the start date for the countdown.

Around the middle of February, I found out I was pregnant. But, I still hadn't squared away the insurance. I had my first doctor's appointment and got a due date of October 20...10 measly days before I assumed my insurance would kick in. We prepared ourselves for the fact that we would have to incur the cost of the entire pregnancy, delivery and all, but I thought I'd make one more call to the insurance company to find out when the 10-month waiting period would be over. I had even written a letter mentioning the mix-up in the application process, and asking if perhaps an exception could be granted to move up the date of maternity coverage, for all of the hassle I'd been through. (It really was a hassle - I had to prove that the box had been checked by getting the original copy from my insurance broker, faxing it in, following up with the appeals department, etc. I thought the least BCBS could do was cover my delivery expenses!)

Turns out, I didn't even need to beg. I called up and asked about my maternity coverage, bracing myself to hear a coverage date of November 1st. The lady on the phone said, "According to your file, you've had maternity coverage since January 1st." Wooooohoooooo! I managed to remain calm on the phone, and asked about the 10-month waiting period. She said there usually was, but mentioned that she had a memo from the company dated something like 12/18/07 stating that going forward, if maternity coverage is requested at the onset of an application and if the applicant is not pregnant on that first date of coverage, coverage can begin immediately. What fabulous news!!!

Johnny and I were ecstatic, but we were wary. We just didn't want to bank on the fact that the expenses would be fully covered, if in fact there had been a mistake. But after almost 25 weeks of pregnancy, and more than a half a dozen sonograms, doctor's appointments, and blood tests galore, I think it's safe to say that I am fully covered, based upon the absence of charges from the insurance company. Oh, there are plenty of ancillary charges for all of the tests they run, but nothing compared to the cost of the procedures without insurance.

Someone was really watching out for us during this time...someone who wanted Bun to come into this world just as badly as we did. Bun - you would have been worth any dollar amount in the world...but at this point, I'm pretty glad you're covered!

BUY THE BOOK

Sara Gorman

In 2001, I was diagnosed with systemic lupus, at the age of 26. I had been married less than 6 weeks and was at a highpoint in my career in television production. While I fought to keep hold of the life I'd known - demanding, yet fulfilling career, busy social life, packed vacation schedule - after four years of running my body into the ground, I realized I was fighting life, not living it. Thus, I downshifted almost every aspect of my life. I let go of my career and made it my number one priority to get myself back in good health. I'm proud to say that I've reached my goal, but work each day to maintain that healthy lifestyle. despite lupus. My book details the steps it took to reach that goal. A native of Indiana and graduate of the University of Notre Dame, I reside in Alexandria, Virginia with my husband, two young daughters, and pug dog.